Reproducibility of cerebral tissue oxygen saturation measurements by near-infrared spectroscopy in newborn infants

Abstract

Early detection of cerebral hypoxemia is an important aim in neonatology. A relevant parameter to assess brain oxygenation may be the cerebral tissue oxygen saturation (StO(2)) measured by near-infrared spectroscopy (NIRS). So far the reproducibility of StO(2) measurements was too low for clinical application, probably due to inhomogeneities. The aim of this study was to test a novel sensor geometry which reduces the influence of inhomogeneities. Thirty clinically stable newborn infants, with a gestational age of median 33.9 (range 26.9 to 41.9) weeks, birth weight of 2220 (820 to 4230) g, postnatal age of 5 (1 to 71) days were studied. At least four StO(2) measurements of 1 min duration were carried out using NIRS on the lateral head. The sensor was repositioned between measurements. Reproducibility was calculated by a linear mixed effects model. The mean StO(2) was 79.99 ± 4.47% with a reproducibility of 2.76% and a between-infant variability of 4.20%. Thus, the error of measurement only accounts for 30.1% of the variability. The novel sensor geometry leads to considerably more precise measurements compared to previous studies with, e.g., 5% reproducibility for the NIRO 300. The novel StO (2) Abstract. Early detection of cerebral hypoxemia is an important aim in neonatology. A relevant parameter to assess brain oxygenation may be the cerebral tissue oxygen saturation (StO 2 ) measured by near-infrared spectroscopy (NIRS). So far the reproducibility of StO 2 measurements was too low for clinical application, probably due to inhomogeneities. The aim of this study was to test a novel sensor geometry which reduces the influence of inhomogeneities. Thirty clinically stable newborn infants, with a gestational age of median 33.9 (range 26.9 to 41.9) weeks, birth weight of 2220 (820 to 4230) g, postnatal age of 5 (1 to 71) days were studied. At least four StO 2 measurements of 1 min duration were carried out using NIRS on the lateral head. The sensor was repositioned between measurements. Reproducibility was calculated by a linear mixed effects model. The mean StO 2 was 79.99 ± 4.47% with a reproducibility of 2.76% and a between-infant variability of 4.20%. Thus, the error of measurement only accounts for 30.1% of the variability. The novel sensor geometry leads to considerably more precise measurements compared to previous studies with, e.g., ∼5% reproducibility for the NIRO 300.

In vivo precision assessment of a near-infrared spectroscopy-based tissue oximeter (OxyPrem v1.3) in neonates considering systemic hemodynamic fluctuations

“…This approach has been used in previous studies, for instance, in Ref. 16. We evaluated StO 2 of ROI 1 and ROI 2 individually as well as their average StO 2 (ROI 1þ2 ) and included all data, irrespective of artifacts caused by drops in SpO 2 or subject movement ("all available").…”

The Effect of Basic Assumptions on the Tissue Oxygen Saturation Value of Near Infrared Spectroscopy

“…First, 30 newborn infants have been studied previously in our group with the aim to identify precision of NIRS [9]. Second, eight adult subjects (all male, age range 26-45, median 29.5) were investigated within a still ongoing study.…”

“…The sensor was repositioned between the measurements [9]. Adult group: Five repeated measurements per subject were taken from the nondominant forearm, near to musculus brachioradialis.…”

Bedside monitoring of patients with shock using a portable spatially-resolved near-infrared spectroscopy

“…Two detectors and a 3-wavelengths (735, 805, and 850 nm) integrated LED were integrated into a probe ( Fig. 1(a)) [17,18]. The LED was controlled by a micro-controller to be "on" or "off" alternatively.…”